RT Journal Article SR Electronic T1 C-reactive Protein and Future Risk of Clinical and Molecular Subtypes of Colorectal Cancer JF Cancer Epidemiology Biomarkers & Prevention JO Cancer Epidemiol Biomarkers Prev FD American Association for Cancer Research SP 1482 OP 1491 DO 10.1158/1055-9965.EPI-19-1339 VO 29 IS 7 A1 Bodén, Stina A1 Myte, Robin A1 Harbs, Justin A1 Sundkvist, Anneli A1 Zingmark, Carl A1 Löfgren Burström, Anna A1 Palmqvist, Richard A1 Harlid, Sophia A1 Van Guelpen, Bethany YR 2020 UL http://cebp.aacrjournals.org/content/29/7/1482.abstract AB Background: Inflammation has been implicated in colorectal cancer etiology, but the relationship between C-reactive protein (CRP) and colorectal cancer risk is unclear. We aimed to investigate the association between prediagnostic plasma CRP concentrations and the risk of clinical and molecular colorectal cancer subtypes.Methods: We used prospectively collected samples from 1,010 matched colorectal cancer case–control pairs from two population-based cohorts in Northern Sweden, including 259 with repeated samples. Conditional logistic regression and linear mixed models were used to estimate relative risks of colorectal cancer, including subtypes based on BRAF and KRAS mutations, microsatellite instability status, tumor location, stage, lag time, and (using unconditional logistic regression) body mass index.Results: CRP was not associated with colorectal cancer risk, regardless of clinical or molecular colorectal cancer subtype. For participants with advanced tumors and blood samples <5 years before diagnosis, CRP was associated with higher risk [OR per 1 unit increase in natural logarithm (ln) transformed CRP, 1.32; 95% confidence interval (CI), 1.01–1.73]. CRP levels increased over time, but average time trajectories were similar for cases and controls (Pinteraction = 0.19).Conclusions: Our results do not support intertumoral heterogeneity as an explanation for previous inconsistent findings regarding the role of CRP in colorectal cancer etiology. The possible association in the subgroup with advanced tumors and shorter follow-up likely reflects undiagnosed cancer at baseline.Impact: Future efforts to establish the putative role of chronic, low-grade inflammation in colorectal cancer development will need to address the complex relationship between systemic inflammatory factors and tumor microenvironment, and might consider larger biomarker panels than CRP alone.